Back to School Health Issues

Immunizations, chronic health conditions, medicines at school -- whatever the issue, if it concerns your child's health and school, we have someone you for you to talk to. In-house pediatrician Steven Parker, MD, joined us for a Q and A session on Aug. 5, 2004.

The opinions expressed herein are the guests' alone and have not been
reviewed by a WebMD physician. If you have questions about your health, you
should consult your personal physician. This event is meant for informational
purposes only.

MODERATOR:Welcome back to WebMD Live, Dr. Parker. When people think
back to school health issues, they think about being up to date on
immunizations. Has most of the controversy about vaccines been put to rest, or
are some parents still holding out?

PARKER:The answer to your question is both. I believe the question of whether vaccinations are associated with the development of autism has been put to rest. There are now many studies showing that, for example, the MMR vaccine is not related to the development of autism. Additionally, the concerns of the older vaccines that contained a mercury compound have also been shown to be unrelated to autism. One proof of this is that since vaccines no longer have thimerosal, there has been no drop in the frequency of the diagnosis of autism.

In a wonderful survey of scientists, when asked what the greatest inventions of the 20th century were, immunizations for children are always among the top two or three. They have saved millions of children's lives. I remain concerned that despite the clear benefits of vaccinations for children and the rare or unproved significant side effects that may accompany them, some parents still choose not to immunize their children. Huge mistake, in my book! Make sure your children receive all of the immunizations. The odds are much, much greater that it will do good than cause any long-term harm.

MEMBER QUESTION:My friend's daughter will be 3 in December. I have a feeling that she has autism. She constantly rocks herself. She plays by herself when she does play. She seems to have the intelligence of my son who will be 2 in October. Someone else has told my friend they believe her daughter might have autism, and she was offended. How can I tell her she may need to get her checked? I don't want to say she has it, but she just does not act like a normal toddler to me.

PARKER:This is a very delicate and not uncommon issue: What to do if you believe someone's child might have a significant problem and the parents are not open to your ideas? I think you're right in explaining to them why the concerns that you've laid out in your message, but also to say that you don't know if the child might have a problem. I would ask them their thoughts. Do you think your child is behind in his or her language? Do you wonder if the way she plays is different than other 3-year-olds?

If the parents deny any of the behaviors that you see, you are unlikely to get anywhere with them. However, if they do agree that the child is showing some of these behaviors, then I think the next step is simply to suggest they bring their child to her pediatrician to look into this further. You may not even want to use the word "autism" as the fear their child might have it could be generating the denial.

The bottom line: They are her parents and they're going to have to make the decision themselves. You certainly can't force them, but in a supportive and gentle way, see if you can help them to examine this potential area more clearly. From what you've written, I do believe this child should have an assessment to try to figure out what, if anything, might be going on. This is important because for most potential challenges, the earlier an intervention is started, the better the long-term outcome.

Good luck. Let me know how things go on my WebMD message board.

"I believe the question of whether vaccinations are associated with the development of autism has been put to rest."

MEMBER QUESTION:Hello, I have a 10-year-old daughter who is extremely obese. She has just been diagnosed with high blood sugars and will see a dietician. She also is scheduled to have her tonsils out in four weeks. They want to keep her overnight because of weight. Is it safe to put her under anesthesia or should I wait six months till she loses weight on her new diet plan?

PARKER:I think the answer to your question, in part, must be decided by why the tonsils are being taken out. If the reason is obstructive sleep apnea I don't think I would wait because of the potential consequences of that disorder. If the tonsils are being taken out for recurrent strep throat, then there is less urgency in my book. It is true that obesity can make anesthesia and surgical procedures a little more difficult; however, I suspect she will do fine, whether or not the procedure is done now or if you choose to wait. This is a long-term and chronic problem and it's not clear where she will even be in six months and if her risk will be lessened.

I'm glad you're looking for interventions and ways to help your child with this difficult and increasingly important and frequent problem in children. Good luck. Let me know how it goes on my WebMD message board.